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Program Information

Stereotactic Breast Biopsy/MRI/ Ultrasound

W Geiser

D Reeve

W Geiser*, D Reeve*, UT MD Anderson Cancer Center, Houston, TX

SU-B-Salon CD-1 Sunday 10:00:00 AM - 12:00:00 PM Room: Salon CD

BICOE Stereotactic Breast Biopsy and Ultrasound
William Geiser, MS, DABR

In October 2007 the American College of Radiology started a new program called the Breast Imaging Center of Excellence (BICOE). The BICOE designation is awarded to breast imaging centers that have earned accreditation in the ACR’s voluntary breast-imaging accreditation programs including breast ultrasound with ultrasound guided biopsy, stereotactic breast biopsy, as well as the mandatory mammography accreditation program.
Significant changes have been made to the program requirements for breast ultrasound that will need to be implemented by June of 2014in order obtain accreditation. Along with the prone stereotactic breast biopsy systems, several mammography systems have add-on stereotactic biopsy systems that will need to be accredited if the facility wishes to obtain the BICOE designation. This lecture is designed to give the medical physicist the information needed to perform the necessary quality control testing on stereotactic breast biopsy, tomosynthesis guided biopsy and breast ultrasound systems to obtain accreditation for those modalities. With this information the medical physicist will be able to help the facilities that they work with obtain the designation of Breast Imaging Center of Excellence.

Learning Objectives:
1. Understand the annual test requirements for stereotactic breast biopsy systems accredited by the American College of Radiology.
2. Understand the testing requirements for breast ultrasound systems in the ACR BICOE program.
3. Help facilities obtain the designation of Breast Imaging Center of Excellence.

Breast MR Imaging and Quality Control
Donna M. Reeve, MS, DABR, DABMP

MR imaging of the breast is an important adjunct to mammography and ultrasound for the detection of breast cancer and for breast biopsy guidance. Diagnostic breast MRI protocols typically include T2-weighted fat saturated images and 3D T1-weighted dynamic contrast enhanced (DCE) multiphase images using a Gadolinium-based contrast agent. The DCE images are used to determine the kinetic signature of enhancing tissues in order to differentiate between benign and malignant lesions. MR spectroscopy and diffusion weighted images (DWI) may also be acquired in order to provide additional diagnostic information.

The diagnostic value of breast MRI scans can be improved by choosing acquisition parameters that optimize image quality parameters such as SNR, contrast and spatial resolution. As with any MRI protocol, achieving the desired image quality must balance the need for acceptable scan times. The timing and temporal resolution of the DCE series are important considerations.

Breast radiofrequency (RF) coils are phased array coils capable of simultaneous bilateral imaging. A comprehensive breast MRI quality control program is important to assess the performance of the MRI system as well as the breast RF coils.

Learning Objectives:
1. Provide and overview of breast MR imaging and MR-guided biopsy procedures.
2. Describe breast MR image quality criteria and protocol optimization.
3. Discuss the components of a breast MRI quality control program.


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